Good point about the shakiness. Yes--I often get that with epinephrine.

I second Mac - the second dose was impractical if you had to self-administer.  EpiPens and Allerjects are difficult enough when you are mentally and physically compromised.  Plus, even if I was alert enough to give a second dose, I'd be shaking too much from the first dose to do anything that required coordination.  (Every time I've had Epi I got a severe case of shakes/shivers.)  Thus, we never chose it when given the option.

Most first aiders I taught were pretty leery of the second dose as well.  Seeing/using a syringe is scary for people.

We too were not interested in using that device.  The second injection was of no interest to us.  We used Epi Pens at that time.  Loving Auvi Q now.

Schools here would only inject the first dose. I was OK with that. He wore one, had one in the office and the office also had a school owned epi. Plus, highly unlikely an ambulance wouldn't be here by the time a second dose was required.

However.....my insurance wouldn't cover it.  And that was true for most provinces.

We were not interested at all. During reactions where I administered, I was happy for the ease--even though with the first dose of thT twinject it would have been the same.

The school nurse was nervous when she had to administer the Epi to DS. She screwed up and had to give him the second Epi. She would not have been able to handle the twinject.

I will say after giving myself the Epi this last time, it was hard enough to do the Epi on myself. I was not thinking clearly--even afterward. I had some language issues in the ambulance. I don't think I could have managed the twinject if I had to give myself another injection. I could have managed a second Epi. But my second dose came in the ER. 

I know some people loved the twinject.  I did not have one and was not interested in one in the slightest.

I didn't mind it.  It's what we were prescribed first.  I think people were scared of taking it apart and having to actually inject the second dose.

Was it that bad?  Did doctors just not prescribe it enough?